Mental Health Seminar Flashcards
What are the primary considerations when admitting patients to the milieu?
- Orienting to the milieu
- Removing contraband (drugs, alcohol)
- Safety (belts, shoelaces, razors)
- Securing personal possessions
- Head to toe assessment
What are the components of the Mental Status Exam?
A - appearance B - behavior C - cognition D - disorders of thought S - speech I - ideation M - mood vs affect P - perceptual
What is assessed under Appearance (MSE)?
- Overall appearance
- Grooming
- Posture, height, weight
- Level of eye contact
- Scars, tattoos, piercings
- Swelling, bruises, birthmarks
- Do they appear stated age?
- Motor activity (ticks, tremors, habits, hyperactive)
What is assessed under Behavior (MSE)?
- How to they behave?
- Do they pace or stay seated?
- Are they calm or restless?
- Are they agitated?
- Is their behavior appropriate or inappropriate for the environment?
What is assessed under Cognition (MSE)?
Are they oriented x 3?
Are they alert?
What is assessed under Disorders of Thought (MSE)?
Content - delusions (false, fixed ideas) - hallucinations (alteration in sensory perception - can be auditory, visual, tactile, olfactory, or gustatory) Process - how organized are their thoughts? - See DT's for specifics
DT: Flight of ideas
words and ideas on unrelated topics but still makes sense
DT: Associative looseness
Similar to flight of ideas
Have a basis in fantasy rather than reality
DT: Circumstantiality
Verbalizations are lengthy and tedious
Delayed in reaching point
DT: Tangentiality
Similar to circumstantiality
Never reach the point
DT: Neologisms
Words that the patient makes up
Have meaning to the patient
DT: Concrete thinking
Patient takes things literally
DT: Clang Association
Speaking in rhyme
DT: Word Salad
Mixing up words without connections between them
DT: Perseveration
Repeatedly say the last word of a sentence
DT: Magical thinking
Belief that they can act on the world around them
Ex: “I can turn off the TV with my mind”
DT: Paranoia
Belief that things are going to happen to them
Hypervigilence
DT: Phobias
Irrational fear
DT: Illusions
See a physical object but think it is something else
Ex: dotted wall paper = bugs
DT: Delusions
Belief in a conviction despite proof to the contrary
Delusion of grandeur - they are very powerful/rich
Delusion of persecution - everyone is out to get them
Delusion of reference - assume everyone is talking about them (people, TV’s, etc)
Delusion of control - believe someone is controlling them
Somatic delusion - believe part of body is non-functional
Nihilistic delusion - believe part of body or world does not exist
Erotomania - believe someone else is romantically involved with them
DT: Echopraxia
repeat what a person does
DT: Echolalia
repeat what a person says
What is assessed under Speech (MSE)?
Rate, volume, and organization of speech
What is assessed under Ideation (MSE)?
Do they have ideas of harm?
- suicidal ideation - harm themselves
- homicidal ideation - harm others
What is assessed under Mood vs Affect (MSE)?
Mood - subjective, what they feel inside
Affect - outward expression
What does labile mean (MVA)?
when a person’s mood goes from one extreme to another and back.
What are some types of affect (MVA)?
Incongruent affect - say they are sad but are laughing
Congruent affect - outward expression matches stated mood
Constricted affect - have no outward sign
Flat affect - expressionless
Blunted affect - start to show mood but pull back
What are the components of the Psychosocial Assessment?
H - home/environment (includes relationships)
E - education level and employment status
A - activities they enjoy
D - do you use drugs/alcohol/tobacco?
S - suicide risk
S - sexuality (are they accustomed to violence or abuse)
S - savagery
What are the Psychosocial Vital Signs?
C - coping
A - anxiety level
P - perception (theirs)
S - support
